{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:03:08Z","timestamp":1792177388041,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T00:00:00Z","timestamp":1732752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["RCS 10\u2010391"],"award-info":[{"award-number":["RCS 10\u2010391"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["1K23 AG058788\u201003"],"award-info":[{"award-number":["1K23 AG058788\u201003"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R24AG064025"],"award-info":[{"award-number":["R24AG064025"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stopping or reducing risky or unneeded medications (\u201cdeprescribing\u201d) could improve older adults' health. Electronic health data can support observational and intervention studies of deprescribing, but there are no standardized measures for key variables, and healthcare systems have differing data types and availability. We developed definitions for chronic medication use and discontinuation based on electronic health data and applied them in a case study of benzodiazepines and Z\u2010drugs in five diverse US healthcare systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of adults age 65+ from 2017 to 2019 with chronic benzodiazepine or Z\u2010drug use. We determined whether sites had access to medication orders and\/or dispensings. We developed definitions for chronic use and discontinuation using both data types. Discontinuation definitions were based on (1) gaps in medication availability during follow\u2010up or (2) not having medication available at a fixed time point. We examined the impact of varying the gap length and requiring a 30\u2010day period without orders\/dispensings (\u201chalo\u201d) around the fixed time point. We compared results derived from orders versus dispensings at one site.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Approximately 1.6%\u20132.6% of older adults had chronic benzodiazepine\/Z\u2010drug use (total\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20096775, ranging from 431 to 2122 across sites). Depending on the definition and site, the proportion discontinuing use during 12\u2009months ranged from 6% to 49%. Requiring a longer gap or a 30\u2010day \u201chalo\u201d resulted in lower estimates. At one site, only 56% of those with chronic use defined from orders also qualified based on dispensings, and the discontinuation rate at 180\u2009days was 20% from orders versus 32% from dispensings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Requiring a gap of \u226590\u2009days or a \u201chalo\u201d around a time point may more accurately capture discontinuation than using a shorter gap or no halo. Orders data underestimate discontinuation compared to dispensings. Work is needed to adapt these definitions for other drug classes and settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19280","type":"journal-article","created":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T08:39:43Z","timestamp":1732783183000},"page":"399-410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Defining key deprescribing measures from electronic health data: A multisite data harmonization project"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6649-3659","authenticated-orcid":false,"given":"Sascha","family":"Dublin","sequence":"first","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle Washington USA"},{"name":"Department of Epidemiology University of Washington  Seattle Washington USA"},{"name":"Kaiser Permanente Bernard J. Tyson School of Medicine  Pasadena California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ladia","family":"Albertson\u2010Junkans","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3589-764X","authenticated-orcid":false,"given":"Thanh Phuong","family":"Pham Nguyen","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9047-0051","authenticated-orcid":false,"given":"Juliessa M.","family":"Pavon","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine  Durham North Carolina USA"},{"name":"Durham VA Geriatric Research, Education, and Clinical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Nicole","family":"Hastings","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine  Durham North Carolina USA"},{"name":"Durham VA Geriatric Research, Education, and Clinical Center  Durham North Carolina USA"},{"name":"Durham VA Center of Innovation to Accelerate Discovery and Practice Transformation  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew L.","family":"Maciejewski","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine  Durham North Carolina USA"},{"name":"Durham VA Center of Innovation to Accelerate Discovery and Practice Transformation  Durham North Carolina USA"},{"name":"Department of Population Health Sciences Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Willis","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Zepel","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Hennessy","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen B.","family":"Albers","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Colorado Institute for Health Research  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Mowery","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy 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